<form id="edit-form" class="form-horizontal" role="form" data-toggle="validator" method="POST" action="">
	 <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Type')}:</label>

            <div class="col-xs-12 col-sm-8 ">
                 <select class="form-control selectpicker" data-rule="required" name="type">
                       <option value="2"  >{:__('Family_list')}</option>
                        <option value="1"  >{:__('Teacher_list')}</option>
                        <option value="3"  >{:__('Promote_list')}</option>
                 </select>
          </div>
       </div> 
       <div class="form-group">
            <label for="c-image" class="control-label col-xs-12 col-sm-2">文件:</label>
            <div class="col-xs-12 col-sm-8">
                <div class="input-group">
                    <input id="c-import" class="form-control" size="50" name="row[import]" type="text" value="">
                    <div class="input-group-addon no-border no-padding">
                        <span><button type="button" id="plupload-import" class="btn btn-danger plupload" data-input-id="c-import" data-mimetype="csv,xls,xlsx" data-url="{:url('ajax/upload')}" data-multiple="false" data-preview-id="p-import"><i class="fa fa-upload"></i> {:__('Upload')}</button></span>
                       
                    </div>
                    <span class="msg-box n-right"></span>
                </div>
                <ul class="row list-inline plupload-preview" id="p-image"></ul>
            </div>
        </div>
       <div class="form-group">
            <label class="control-label col-xs-12 col-sm-2">领取物品:</label>
            <div class="col-xs-12 col-sm-8">
                <input id="c-book_name" data-rule="required" class="form-control" name="book[book_name]" type="text" value="">
                <span class="help-block">例：素材书C2一册</span>
            </div>
        </div>
        <div class="form-group">
            <label class="control-label col-xs-12 col-sm-2">领取日期:</label>
            <div class="col-xs-12 col-sm-8">
                <input id="c-date" data-rule="required" class="form-control" name="book[date]" type="text" value="">
                 <span class="help-block">例：8月3日（本周六）</span>
            </div>
           
        </div>  
        <div class="form-group">
            <label class="control-label col-xs-12 col-sm-2">领取地址:</label>
            <div class="col-xs-12 col-sm-8">
                <input id="c-address" data-rule="required" class="form-control" name="book[address]" type="text" value="">
                <span class="help-block">例：大同市阳光书城（平城区253号）</span>
            </div>
        </div>        
        <div class="form-group">
            <label class="control-label col-xs-12 col-sm-2">仅限日期:</label>
            <div class="col-xs-12 col-sm-8">
                <input id="c-only_date" data-rule="required" class="form-control" name="book[only_date]" type="text" value="">
                <span class="help-block">例：8月3日当日</span>
            </div>
        </div>        
       <div class="form-group">
            <label class="control-label col-xs-12 col-sm-2">乘车路线:</label>
            <div class="col-xs-12 col-sm-8">
                <input id="c-car" data-rule="required" class="form-control" name="book[car]" type="text" value="">
                <span class="help-block">例：地铁10、13号线知春路站（B南口，需步行700米）；公交车：323、600、特19路青云路站</span>
            </div>
        </div>
        <div class="form-group">
            <label class="control-label col-xs-12 col-sm-2">咨询电话:</label>
            <div class="col-xs-12 col-sm-8">
                <input id="c-tel_phone" data-rule="required" class="form-control" name="book[tel_phone]" type="text" value="">
                <span class="help-block">例：88892731</span>
            </div>
        </div>
     <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Message_check')}:</label>
        <div class="col-xs-12 col-sm-8">
            
            <input  id="c-status" name="status" type="hidden" value="1">
            <a href="javascript:;" data-toggle="switcher" class="btn-switcher" data-input-id="c-status" data-yes="2" data-no="1" >
                <i class="fa fa-toggle-on text-success fa-flip-horizontal text-gray fa-2x"></i>
            </a>
             <span class="help-block">{:__('Sample Note')}</span>
        </div>
    </div>
    <div class="form-group layer-footer">
        <label class="control-label col-xs-12 col-sm-2"></label>
        <div class="col-xs-12 col-sm-8">
            <button type="button" class="btn btn-success btn-embossed " id="submitbtn">{:__('Send')}</button>
        </div>
    </div>
</form>
